<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN"
    "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
    
<html lang="en">
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
    
    <?php $this->load->view('header/css.php'); ?>
    <?php $this->load->view('header/js.php'); ?>
    <script type="text/javascript">
        $(function() {
            $("#datepicker").datepicker({
                dateFormat: 'yy-mm-dd',
                changeMonth: true,
                changeYear: true,
                yearRange: 'c-100:c'
            });
        });
    </script>
    <title><?=lang('signup.Signup')?></title>
</head>
<body>
	<div id="page">
	    <div id="header" class="clearfix">
	            <div id="headerimg">
	                <div  class="container" style="text-align: right">
	                    <span class="span-2"><img src="/images/favl_logo_small.gif" style="margin-top: -5px" /></span>
	                    <h1><?=lang('signup.Signup')?></h1>
	                </div>
	            </div>
	        <div id="navigation">
	            <div class="container">
	                <ul id="nav">
	                    <li class="active"><a href="/"><?=lang('welcome.Welcome')?></a> &nbsp; // &nbsp; </li>
	                    <li><a href="http://www.favl.org.ar">FAVL</a></li>
	                </ul>
	            </div>
	        </div>
	    </div><!-- /#header -->
	    <div id="main">
	        <div class="container">
	            <div class="span-17 colborder last" id="content">
	                <?php if (isset($messages)) echo $messages; ?>
					<div id="signup-form" class="span-16 last">
						<?php echo form_open('signup'); ?>
                        <fieldset class="box">
                            <legend class="caps"><?=lang('signup.Mandatory_Data')?></legend>
							<div class="span-7">
								<p>
									<label for="username"><?=lang('login.CIVL_ID')?>: </label>
									<?php echo form_input('id',set_value('id')); ?>
								</p>
								<p>
									<label for="password"><?=lang('login.Password')?>: </label> 
									<?php echo form_password('password'); ?>
								</p>
								<p>
									<label for="passconf"><?=lang('signup.Confirm_Password')?>: </label> 
									<?php echo form_password('passconf'); ?>
								</p>
	                        </div>
	                        <div class="span-7 last">
								<p>
									<label for="name"><?=lang('profile.Name')?>: </label> 
									<?php echo form_input('name',set_value('name')); ?>
								</p>
								<p>
									<label for="email_primary"><?=lang('profile.EMail')?>: </label> 
									<?php echo form_input('email_primary',set_value('email_primary')); ?>
								</p>
							</div>
                        </fieldset>
	                    <div class="span-16 last form-actions-panel">
	                       <p><?php echo form_submit('action',lang('signup.Create_Account')); ?></p>
	                    </div>
						<div class="span-16 last">
                        <fieldset class="box">
                            <legend class="caps"><?=lang('signup.Optional_Data')?></legend>
                            <div class="span-7">
								<p>
									<label for="nac_type"><?=lang('profile.NAC_Type')?>: </label> 
									<?php echo form_dropdown('nac_type', 
										array(
											'LE' => 'Libreta Enrolamiento',
											'LC' => 'Libreta Civica',
											'PASS' => 'Pasaporte',
											'DNI' => 'DNI',
											'CI' => 'Cedula Identidad'), 'PASS'); ?>
								</p>
								<p>
									<label for="nac"><?=lang('profile.NAC_ID')?>: </label> 
									<?php echo form_input('nac',set_value('nac')); ?>
								</p>
								<p>
									<label for="address_line_1"><?=lang('profile.Address')?>: </label> 
									<?php echo form_input('address_line_1',set_value('address_line_1')); ?>
									<?php echo form_input('address_line_2',set_value('address_line_2')); ?>
								</p>
								<p>
									<label for="location"><?=lang('profile.Location')?>: </label> 
									<?php echo form_input('location',set_value('location')); ?>
								</p>
								<p>
									<label for="postcode"><?=lang('profile.Postcode')?>: </label> 
									<?php echo form_input('postcode',set_value('postcode')); ?>
								</p>
								<p>
									<label for="country_code"><?=lang('profile.Country')?>: </label> 
									<?php echo form_input('country_code',set_value('country_code')); ?>
								</p>
							</div>
							<div class="span-7">
								<p>
									<label for="dob"><?=lang('profile.DOB')?>: </label> 
									<input type="text" name="dob" id="datepicker" size="10" maxlength="10" /></p>
								<p>
									<label for="email_alternate"><?=lang('profile.Alternative_Email')?>: </label> 
									<?php echo form_input('email_alternate',set_value('email_alternate')); ?>
								</p>
								<p>signup/index
									<label for="phone_work"><?=lang('profile.Phone_Work')?>: </label> 
									<?php echo form_input('phone_work',set_value('phone_work')); ?>
								</p>
								<p>
									<label for="phone_home"><?=lang('profile.Phone_Home')?>: </label> 
									<?php echo form_input('phone_home',set_value('phone_home')); ?>
								</p>
								<p>
									<label for="phone_mobile"><?=lang('profile.Phone_Mobile')?>: </label> 
									<?php echo form_input('phone_mobile',set_value('phone_mobile')); ?>
								</p>
								<p>
									<label for="gender"><?=lang('profile.Gender')?>: </label> 
									<?php echo form_dropdown('gender', 
										array(
											'M' => 'Male',
											'F' => 'Female',
											'O' => 'Other')); ?>
								</p>
							</div>
							</fieldset>
						</div>
		                <?php echo form_close(); ?>
		            </div>
	            </div> <!-- end content -->
		        <div class="span-6 prepend-1 last" id="sidebar">
                   <div class="box">
                        <h3 class="caps">FAVL</h3>
                        <p><?=lang('login.Favl_Migration_message')?></p>
                        <?php echo form_open('favl/one')?>
                        <p>
                            <label for="favl_id"><?=lang('login.Favl_ID')?>: </label> 
                            <?php echo form_input('favl_user',set_value('favl_user')); ?>
                        </p>
                        <p>
                            <label for="leonardo_pass"><?=lang('login.Favl_Password')?>: </label> 
                            <?php echo form_password('favl_pass',set_value('favl_pass')); ?>
                        </p>
                        <div class="last form-actions-panel">
                           <p><?php echo form_submit('action',lang('signup.Migrate_Account')); ?></p>
                        </div>
                        <?php echo form_close(); ?>
                   </div>
                   <div class="box">
                        <h3 class="caps"><?=lang('login.Leonardo')?></h3>
                        <p><?=lang('login.Migration_message')?></p>
                        <?php echo form_open('leonardo/one')?>
                        <p>
                            <label for="leonardo_id"><?=lang('login.Leonardo_Username')?>: </label> 
                            <?php echo form_input('leonardo_user',set_value('leonardo_user')); ?>
                        </p>
                        <p>
                            <label for="leonardo_pass"><?=lang('login.Leonardo_Password')?>: </label> 
                            <?php echo form_password('leonardo_pass',set_value('leonardo_pass')); ?>
                        </p>
                        <div class="last form-actions-panel">
                           <p><?php echo form_submit('action',lang('signup.Create_Account')); ?></p>
                        </div>
                        <?php echo form_close(); ?>
                   </div>
		       </div>
            </div> <!-- end container -->
	    </div> <!-- end main -->
    </div> <!-- end page -->
</body>
</html>
